Minimal invasive interventions allow the treatment of lesions without the strain of full open surgery. Such image guided interventions and therapies fully rely on the guidance and navigation based on real-time peri-interventional imaging equipment, such as interventional X-ray and ultrasound. Since these imaging modalities are the ‘eyes’ of the treating physician, the associated image quality and imaging features are essential. The addition and further development of 3D imaging capabilities in recent years has broadened the possibilities and capabilities of such procedures, and enabled minimal invasive treatment that could only be performed by open surgery in the past. In this chapter we describe several recent innovations in the area of 3D interventional X-ray imaging in the areas of image quality, 3D model-based catheter reconstruction, multi-modal image fusion, and stereoscopic visualizations.